A Case of Fatal Ingestion of a 10% Benzalkonium Chloride Solution

A Case of Fatal Ingestion of a 10% Benzalkonium Chloride Solution

Benzalkonium chloride (BAC) is a mixture of quaternary ammonium compounds of alkyl-dimethylbenzylammonium chlorides. It has wide ranging use as a disinfectant, germicidal cleaner, algaecide, cationic detergent and topical dermal antiseptic. Ingestion of BAC can cause local caustic effects and systemic effects. The present report involved a 78 year old male with a history of severe dementia who ingested up to 240ml of a germicidal disinfectant containing 10% benzalkonium chloride. Shortly after, he complained of oral pain and nausea, and experienced one episode of vomiting. Upon arrival to the emergency department approximately 45 minutes post-ingestion the patient’s complaints included oral pain, sialorrhea, drooling, spitting, nausea, and coughing, but no increase in work of breathing. Initial evaluation of the oral cavity and oropharynx showed mild erythema and swelling, but without lesions or erosions.